The University of Texas MD Anderson Cancer Center, Department of Gynecologic Oncology and Reproductive Medicine, Houston, TX, United States of America.
The University of Texas MD Anderson Cancer Center, Department of Gynecologic Oncology and Reproductive Medicine, Houston, TX, United States of America.
Gynecol Oncol. 2019 Mar;152(3):514-521. doi: 10.1016/j.ygyno.2018.11.027.
We assessed preferences for cancer risk management strategies for Lynch syndrome (LS) in LS-affected women.
Women with LS aged ≥25 years evaluated 9 cancer risk management strategies using a visual analog scale (VAS) and modified standard gamble (SG). For the VAS, women ranked each strategy ranging from 0 (least preferred) to 100 (most preferred). VAS scores were calculated by dividing the corresponding number by 100. Scores closer to 1.0 reflected more favorable strategies. For the SG, participants were asked to specify their expected threshold of lifetime risk of endometrial or colorectal cancer, ranging from 0 to 100%, at which they would consider undertaking each strategy. Strategies included chemoprevention, cancer screening, and preventive surgery. Cancer worry and perceived cancer risk measures were collected on a subset of participants.
Sixty-one women completed preference assessments. By VAS, annual combined screening was the most preferred, followed by annual screenings and chemoprevention with oral contraceptives. By SG, women were the most willing to endorse oral contraceptives and biannual screening strategies at the lowest threshold of lifetime risk followed by annual screening strategies. Surgical interventions were the least preferred strategies using both VAS and SG. Women with a family history of gynecologic or colorectal cancer were less likely to consider prevention or screening options compared to women without a family history. Cancer worry was higher among women with a positive family history of LS cancer.
Understanding women's preferences may facilitate optimal use and adherence to cancer risk management strategies.
我们评估了林奇综合征（LS）患者对 LS 相关女性癌症风险管理策略的偏好。
年龄≥25 岁的 LS 女性使用视觉模拟量表（VAS）和改良标准博弈（SG）评估了 9 种癌症风险管理策略。在 VAS 中，女性将每种策略按 0（最不喜欢）到 100（最喜欢）进行排名。VAS 评分通过将相应数字除以 100 得出。分数越接近 1.0，表明策略越有利。在 SG 中，参与者被要求指定他们愿意接受每种策略的终生子宫内膜癌或结直肠癌风险的预期阈值，范围从 0 到 100%。策略包括化学预防、癌症筛查和预防性手术。在一部分参与者中还收集了癌症担忧和感知癌症风险的测量结果。
61 名女性完成了偏好评估。通过 VAS，年度联合筛查是最受欢迎的，其次是年度筛查和口服避孕药的化学预防。通过 SG，女性在最低的终生风险阈值下最愿意接受口服避孕药和每两年筛查的策略，其次是每年筛查的策略。手术干预是使用 VAS 和 SG 时最不受欢迎的策略。有妇科或结直肠癌家族史的女性与没有家族史的女性相比，不太可能考虑预防或筛查方案。有 LS 癌症阳性家族史的女性癌症担忧程度更高。
了解女性的偏好可以促进癌症风险管理策略的最佳使用和依从性。
